Key result
Wearable devices combined with usual care reduced major adverse cardiovascular events (RR 0.75; 95% CI 0.57-0.98) and all-cause mortality in patients with ischemic heart disease.
Why the study?
To evaluate the impact of wearable devices combined with usual care compared with usual care alone on the incidence of MACE in patients with ischemic heart disease.
Do wearable devices added to usual care reduce major adverse cardiovascular events in adults with ischemic heart disease?
Meta-Analysis
Do wearable devices added to usual care reduce major adverse cardiovascular events in adults with ischemic heart disease?
Relative Risk: 0.75 (95% CI 0.57–0.98)
Wearable devices combined with usual care may reduce MACE and all-cause mortality in patients with ischemic heart disease, though current evidence is of low certainty.
Supports wearable integration into ischemic heart disease care; reinforces outcome benefits from aggregated Level 1 evidence.
OBJECTIVES: To evaluate the impact of wearable devices when associated with usual care on the incidence of major adverse cardiovascular events (MACE) in patients with ischemic heart disease compared with usual care alone. METHODS: Randomised clinical trials with patients aged 18 years and above with ischemic heart disease, using wearable devices and assessing at least one of the primary outcomes (myocardial infarction, stroke, cardiovascular mortality, or major adverse cardiovascular events) or secondary outcomes (all-cause mortality, hospitalisation, all arrhythmias, heart failure, unstable angina or revascularisation procedures) were included. MEDLINE, EMBASE, Cochrane Library, CINHAL, INAHTA and the Web of Science Core Collection were searched in April 2024. Studies were also identified via citation searching. Cochrane Risk of Bias version 1 was applied as provided in Covidence. Meta-analyses were performed when possible. RESULTS: Six studies of moderate quality were included. Wearables showed positive effects in reducing major adverse cardiovascular events (RR 0.75, 95 % CI 0.57-0.98, two studies) and all-cause mortality (RR 0.64, 95 % CI 0.43-0.96, three studies); no significant effects were found on myocardial infarction (RR 0.89, 95 % CI 0.59-1.34, four studies), cardiovascular mortality (RR 0.35, 95 % CI 0.07-1.73, three studies), hospitalisations (RR 0.77, 95 % CI 0.56-1.07, five studies), all arrhythmias (RR 1.10, 95 % CI 0.49-2.48, two studies), and heart failure (RR 0.85, 95 % CI 0.61-1.18, two studies). Meta-analysis could not be performed for stroke, unstable angina, and revascularisation procedures. Grading of Recommendations Assessment, Development and Evaluation (GRADE) certainty of evidence was deemed low or very low. DISCUSSION: While wearables seem to have some positive effects for patients with ischemic heart disease, only weak recommendations for use are possible. More large-scale, high-quality randomised clinical trials are needed to recommend the routine use of wearables in combination with usual care. PROTOCOL REGISTRATION ON PROSPERO: CRD42024586137.
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Ballavenuto et al. (2024) conducted a meta-analysis in Ischemic heart disease. Wearable devices associated with usual care vs. Usual care alone was evaluated on Major adverse cardiovascular events (MACE) (RR 0.75, 95% CI 0.57-0.98). Wearable devices combined with usual care reduced major adverse cardiovascular events (RR 0.75; 95% CI 0.57-0.98) and all-cause mortality in patients with ischemic heart disease.
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